Physiotherapy:

Any physical problems identified by a health visitor, Consultant, doctor, GP or you from very young babies, children and adolescents will be referred to a paediatric physiotherapist who can help with many childhood conditions. For example your baby may have a physical deformity or developmental delay which is manifested by poor head control or by being late sitting up or walking. As your child matures, foot problems, clumsiness, poor posture, balance or co-ordination, frequent falls, back pain and arthritis may also lead to a referral. The paediatric physiotherapist plays a central role in the management and treatment of children with cerebral palsy and many other special needs conditions.

The physiotherapist works within the NHS Health service in both hospitals and the community.  If your child is of school age, you may find that their physiotherapy programme can be done at school with the help of a teaching assistant. In our experience this is feasible but requires regular liaison and communication with the physiotherapist (the lack of paediatric physiotherapists in our local area tends to be the main problem for delays here)

A consultation typically consists of an initial assessment of specific physical functions and abilities. The initial assessment is followed by a discussion about immediate and long term requirements and a plan for appropriate treatment. Although with children the plan of action for exercise and treatment will be changing as they grow and develop.

Treatment may be given at the child development centre, hospital, local clinics or home, using various techniques such as massage, exercises, neuro-developmental therapy, mobilisation, stretching, strengthening, and posture-education. Whatever techniques are used enthusiastic parental involvement at home is essential for optimal long-term results.

Occupational Therapy (OT):

Paediatric OT’s (provided through the NHS health service) work with children up to the age of 16 years old who may have:

•  A physical disability.

•  Difficulty with co-coordinating movements, particularly for hand function
   and for skills such as handwriting.

•  Perceptual disorders and find it hard to make sense of the world around
   them and have problems especially with learning at school.

Paediatric OT’s work in the best place suited for each child. They aim to make the most of a Childs potential ability in specific areas and to increase their independence at home, school, in their recreational activities and society. They will use therapeutic techniques, adaptations to your child's environment and possibly the use of specialist equipment to achieve this.

Liaising closely with other professionals such as physiotherapists, Consultants, doctors, speech therapists, OT’s working within social services, health visitors, social workers, psychologists, teachers and nursery nurses. More importantly they work with you the parents/carers.

Assessment:

As with all other services an assessment is undertaken when the OT will ask how the child and family see the condition and the foreseen problems.  They will talk to other professionals who know the child (including teachers) and finally carry out specific activities and formal assessments with the child to define the exact nature of any problem.

A typical problem could be a Child distressed by their apparent failure in parts of the school curriculum which can affect the way they react to their surroundings or their ability to carry out skilled movements.

Treatment:

Follows an assessment, the OT may see a child for individual treatment sessions; occasionally children are treated in a group. A programme of exercises and activities to be carried out regularly at school and/or at home is set up. Techniques may vary, but the emphasis is always on learning through enjoyable activities which motivate the child.

The emphasis may be on:-

•  Self-help (e.g. eating, dressing).

•  Co-ordination.

•  Hand function (fine motor skills).

•  Perception (e.g. body and spatial awareness, visual discrimination).

•  Concentration and attention span.

•  Learning social skills (e.g. through therapeutic play).

The aim of any treatment is to make the child as independent as possible in the skills they need for everyday life.

Equipment:

The OT helps the child learn to do everyday activities in ways they can manage on their own; independently. Where necessary, the OT will assess the need for special equipment and arrange for it to be provided, this is reviewed as the child grows or their needs change.

Equipment which may be provided:-

•  Seating, including buggies and wheelchairs.

•  Standing frames.

•  Walking aids.

•  Eating and drinking.

•  Washing.

•  Using the toilet (transfer aids).

•  Handwriting, or using computers.

Unfortunately if your child is at school the equipment provision will normally be supplied for use at school and because the health service is not a bottomless pit of money you will find it difficult to obtain a further piece of the same equipment to keep/use at home. This is very frustrating; because you find that certain items are needed on a daily basis both at school and at home for example standing frames, seats and walkers. Obviously wheelchairs and buggies can be transported daily (if you have a suitable vehicle) but it is not practical to transport other large items on a daily basis. This is where you may find it worth contacting different charities to assist in the purchase of additional equipment for use at home.

Orthotics:

Orthotists work in conjunction with your child's physiotherapist and/or doctor. They provide a range of Specialist Foot and Leg Wear including braces, splints and special footwear to correct any deformity, aid movement, provide support and relieve discomfort. Orthotic devices take many forms, below are some examples:

•  Ankle-Foot-Orthoses (AFO’s) can be used during night or day. They  help to control the unwanted movements in the foot and ankle and can also help the hip and knee position. This in turn can help to improve a child gait, balance and posture.
  
   

•  Piedro boots are orthotic shoes designed for children with disabilities and/or children who require extra arch or ankle support. They look similar to a normal boot but open closer to the toes so they are easier to put on children particularly if their toes curl. Helping to maintain a good foot position for standing (and walking) and may be tried before other orthotic devices such as AFO’s are used. They come in several widths and sizes and the Orthotists will measure your child's foot and size the boot accordingly. They have removable insoles in case they need to be replaced by custom made ones designed and manufactured specifically for your child’s feet, and have extra depth at the toe.

Speech Therapy:

Speech Therapists provide assessment and therapy for a wide range of communication and feeding/swallowing disorders for pre-school and school-aged children, including assessments for Statements of Special Educational Need.

Children with a disability from a very early age will be referred and regularly followed up by a speech therapist. They work closely with parents/carers and liaise with other professionals as appropriate, for example, health visitors, teachers, GPs. If you have any concerns about any aspects of your Childs’ development bring them to the attention of your health visitor, GP or child’s teacher, for example:

• Eating difficulties (chewing and swallowing).

• Stammering or stuttering (can be common up to age 4.

• Language delay.

• Speech delay.

Therapy may be offered as part of/or in the form of:

•  Parent groups.

•  Home programmes.

•  Group sessions.

•  Individual sessions.

Play Therapy:

Play Therapy is a mode of therapy that helps children to explore their feelings, to express themselves and to make sense of their life experiences.

Play is a child's natural medium to learn, communicate and to explore their worlds. Conventional talking therapies may be inappropriate for children and young people who struggle to put their feelings into words. Play Therapy allows children the opportunity to explore and understand these feelings. The resulting empowerment and increased self esteem can be the springboard to help the child to cope with difficulties in the real world.

Play Therapy is an effective intervention for disabled children, it can offer them a space in which the feelings their experiences generate can be expressed and contained. It cannot change what has happened to them but it can promote resilience within each child to enable them to discover a more hopeful view of the world. Play Therapy is appropriate for children of all ages, but is most often used for children aged between three and twelve years. Play Therapists generally work with individual children but many have experience of working with groups and with siblings.

Music Therapy:

Music has always been a powerful tool for expression and has the capacity to touch our emotions deeply.  It is based on the understanding that the ability to respond to and experience oneself through music is an inborn quality in all human beings.  This ability usually remains unimpaired by disability, injury or illness, and is not dependant on musical training.

The music therapist and the child improvise freely together and communicate with each other through their shared music, gradually establishing a musical relationship in which emotions can be expressed, explored and worked through within a safe and confidential environment.

The aims are therapeutic, rather than musical, overall aim is for the therapist to be closely involved with the Childs development to help to achieve their full potential. Some of these can include:

•  Encourage communication skills.

•  Help the child to relate to others.

•  Help the child to build rewarding relationships.

•  Developing a positive and creative means of expressing feelings that
   cannot be put into words.

•  Developing individuality, self awareness, motivation, confidence,
   initiative, creativity and choice.

During a weekly session the child will be encouraged to use their voice and to experiment with the various percussion and melodic instruments available.  These instruments can all be played by someone with no previous skill to create satisfying and expressive sounds. The child will have the opportunity to freely explore the world of sound and create a unique musical language. By responding musically the therapist is able to support and encourage this process of growth and discovery.

   - The first UK radio station for everybody with a disability.